Steven K. McKeown, first assistant chief probation officer of Worcester County Juvenile Court, sees a lot of children who have faced trauma in their lives.

They may be in court for delinquency, having committed a crime; or as a “child requiring assistance,” typically a runaway, someone who skips school or habitually refuses to obey school or home rules; or they may be subject to a “care and protection” hearing in which the state seeks to take them away from their parents because they were born addicted or have otherwise been subject to abuse and neglect.

“The majority of those cases would probably qualify as kids who have experienced trauma,” Mr. McKeown said, particularly about children in care and protection cases. “Something has disrupted their lives significantly.”

But as Mr. McKeown and others who work with troubled children and families can attest, it's not easy getting the services these families need.

A four-year, $1.6 million grant recently awarded to the University of Massachusetts Medical School by the federal Substance Abuse and Mental Health Services Administration, aims to improve access to effective trauma therapy services for children and youths ages 6 to 18 in Central and Western Massachusetts.

Starting in January, the medical school's newly established Child Trauma Training Center will work with pediatricians and professionals in the courts, schools and law enforcement to identify and assess trauma-related symptoms. Hundreds of mental health clinicians will be trained and certified in trauma-focused cognitive-behavioral therapy, and a central referral system accessed through a toll-free number, (855) LINK-KID will help find the nearest trauma-therapy provider with the next available opening.

“That's been a real problem with waiting lists,” Mr. McKeown said. “Right now people feel they're coming in the door saying, 'I need some help,' but the services aren't really there for them.”

Jessica L. Griffin, a clinical and forensic psychologist who has a doctorate in psychology and is an assistant professor of psychiatry and pediatrics at UMass Medical School, serves as principal investigator for the Child Trauma Training Center grant. She said: “Families who have experienced trauma can sometimes wait weeks or months to get treatment. We'll track who has openings and who has waiting lists. We want to get families into good trauma treatment sooner.”

Court-involved youths and children in military families, whose parents may suffer from post-traumatic stress disorder, are among the targeted underserved populations for the training center grant.

Ms. Griffin said that researchers have found in medical records of young kids who entered the foster care system — some as young as 3 and 4 — many examples of trauma-related symptoms, such as bedwetting and headaches.

“Perhaps if somebody intervened sooner, it could have changed the trajectory of their development,” Ms. Griffin said. “We know that trauma has an impact on brain development.”

She said that while children are resilient, trauma — which includes experiencing or witnessing domestic, sexual or physical abuse; suffering loss from a tornado or hurricane; witnessing or being a victim of community violence; even being in a car accident or having parents involved in a high-conflict divorce — can cause about 70 percent of trauma victims to exhibit symptoms. Children may act out or become withdrawn.

Mr. McKeown said that children first seen in the courts for care and protection hearings may branch out to criminal activity or truancy, and then fall under all three of the court's categories of services.

Craig E. Maxim, site director for the Family Continuity Project in Whitinsville and Worcester, one of the area groups of mental health professionals working with the Child Trauma Training Center, said: “What generally happens with children (in trauma) is they'll come up with coping mechanisms that aren't healthy.”

Mr. Maxim said that in trauma-focused cognitive-behavioral therapy, the clinician tries to address cognitive distortions, which are misperceptions surrounding the trauma. For instance, the client may erroneously believe that one bad interaction with the police means that all police officers are bad.

Therapy then focuses on building positive coping skills.

Ms. Griffin said, “The talking about what happened and the telling of the story is extremely healing, but most kids won't talk about it unless given permission to do so.” In cognitive-behavioral therapy, “They're telling their story. They're processing what happened to them.”

Trauma-focused cognitive-behavioral therapy has been shown through several clinical trials to be more effective in a shorter amount of time than traditional, non-directive child therapy or no services at all.

Mr. Maxim said that UMass researchers who have evaluated Family Continuity Project clients served in the trauma-focused cognitive-behavioral therapy model have seen decreased stress on the part of the parents and decreases in children's symptoms.

The Child Trauma Training Center team has already trained several hundred clinicians in Worcester County in trauma-focused cognitive-behavioral therapy. More will be trained, Ms. Griffin said. The goal under the grant is to reach 1,800 professionals, working with 20,000 youths, with trauma-sensitive care and practices.

Actual trauma-focused treatment will be provided to 900 youths and their families in 60 communities in Worcester County and 23 cities and towns in Hampden County, according to the grant overview.

Mr. McKeown said that with funding for mental health services so limited, it was valuable for UMass to demonstrate the effectiveness of the trauma-focused model.

He said if effective services and support can be provided to children and families in the home or in community settings, it's better for families and the public. The cost of community-based therapy alone pales in comparison to the $150,000 per person for a year of residential treatment.

“It's good for UMass to identify what works,” Mr. McKeown said. “Let's prove what we're going to do before we do it.”

Contact Susan Spencer at susan.spencer@telegram.com. Follow her on Twitter @SusanSpencerTG.